O09.291
Supervision of pregnancy with other poor reproductive or obstetric history, first trimester
O09.291 (also written O09291) is a billable ICD-10-CM diagnosis code for supervision of pregnancy with other poor reproductive or obstetric history, first trimester. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 64 codes in category O09 (Supervision of high risk pregnancy). Its coding notes include a Use additional code instruction, 1 Excludes1 entry and 5 Excludes2 entries.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
The trimester character comes from the provider's documentation for the current encounter. The unspecified trimester code should rarely be used.
O09 is used only in the prenatal period. It is first-listed for routine prenatal visits in high-risk pregnancies.
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (1 note)
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Also from chapter/block level (1 note)
- supervision of normal pregnancy (Z34.-)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
- pregnancy care for patient with history of recurrent pregnancy loss (O26.2-)
Also from chapter/block level (4 notes)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Other clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Notes
Also from chapter/block level (6 notes)
- CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
- Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
- Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
- 1st trimester- less than 14 weeks 0 days
- 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
- 3rd trimester- 28 weeks 0 days until delivery